This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Wednesday, April 27, 2016

I Have Seen Some Spin In My Time But This Takes The Biscuit! NEHTA Was An Obstacle, to Not A Supporter of, Progress In Australian E-Health.

The Chair of the Board of the National E-Health Transition Authority (NEHTA) Dr Steve Hambleton has welcomed the news that the disallowance period for the Australian Digital Health Agency (the Agency) had passed and looks forward to the next stage, the transition to the Agency.

"It is with much enthusiasm that I report that digital health is alive and well with confirmation that The Agency has the support of the Parliament and will be fully operational by 1 July 2016," Dr Hambleton said.

This announcement comes just three weeks after the Turnbull Government announced its support for the establishment of 'Health Care Homes' in General Practices that will rely on the My Health Record and digital communication as an enabler to provide personalised comprehensive care and enhance health system integration.

Dr Hambleton paid tribute on behalf of the Board to NEHTA's outgoing CEO Mr Peter Fleming whose stewardship has helped NEHTA deliver on the objectives set for it on its formation 11 years ago. Mr Fleming will pass on responsibility to a collaborative joint transition team for the final two months of the handover of NEHTA's operations to the Agency.

Mr Fleming, who has been NEHTA's CEO since 2008, said that he was proud to be at the helm of NEHTA as it had delivered the cornerstone eHealth foundations in accordance with its charter.

"This has made it possible to deliver the national My Health Record system to achieve the vision set by the Australian health ministers 15 years ago." Mr Fleming said.

He went on to say, "I am extremely proud of the many key employees and contractors to NEHTA that have been involved over the years, in designing and delivering the eHealth foundations that Australia now relies on. All of these dedicated people deserve to be proud of their achievements, which will provide health benefits to the current and future generations."

"NEHTA was tasked to 'develop the standards and provide and manage the development of infrastructure, software and systems required to support connectivity and interoperability of electronic health information systems across Australia' and it has achieved that," said Dr Hambleton.

This includes development and implementation of the key building blocks for a national eHealth system including standards and specifications; identity management; security and authentication; disease and medicines terminology; secure messaging; clinical safety assessment; conformance and compliance management; and procurement and supply chain solutions.

"These are the foundations of eHealth, and they are the envy of many of our international neighbours. There are very few countries in the world that have been able to transition to a uniform national 'eHealth rail gauge'." Dr Hambleton said.

NEHTA's work has also laid the foundations that will be progressed by the Agency to embrace the innovation agenda set by the Turnbull government.

"It is expected that there will be many more innovative ideas that will leverage those foundations and assist Australia to deliver better health outcomes and a much more engaged population," Dr Hambleton said.

I have to disagree with this release. I believe NEHTA has performed very badly, delivered unwanted and unsuccessful systems as well as thousands of pages of unused and unusable specifications.

Given the $1 Billion or more spent on NEHTA it is hard to see any appreciable value that has been delivered.

There is no reason to take my word for this: On page 44 of the Royle Review of the PCEHR we read the following:

“Review Findings

The review has heard from multiple medical industry associations and software providers. A strong theme of constraints being imposed on the industry due to the centralist approach taken with the PCEHR, has been shared.

A perceived centralist approach, led by NEHTA and the Federal Department of Health has been identified as reducing confidence of the private sector to invest in product development and evolution, reducing the willingness to collaborate given multiple comments that information was often shared with NEHTA with little received in return.”

Enough said. NEHTA designed the unused PCEHR and was seen as having damaged the e-Health industry overall - rather than having been a force for good.

I , for one, and thrilled to see it go. We can only hope the ADHA turns out to be a lot better!

The press release attempts a hagiography of a virtually total failure. That the PR is funded by public money is really just hopeless. As a small consolation I now know the dreadful rubbish that was an un-consultative and self obsessed organisation that threatened to sue me for telling the truth are now out of a job. I sure won't miss it! It took 11 years but finally the stupid has been left to disappear!

Also good to see all those rubbish initiatives vanish - such as ehealthcentral. Just paid nonsense which still sits there as a monument to the hubis of NEHTA and DoH, and what you can get when you are spending government money. You guys need to get out more!

As my daughter would say to their demise, Yea!!!

Good riddance NEHTA and all the senior staff who determined its pathetic, confrontational and failed approach. I hope having been part of NEHTA will mean you spend much time thinking about how much better it could have been!

Of course the obvious issue going forward is just how different the new ADHA will be? Right now it is feeling eerily similar to the old NEHTA and to be a tooth less tiger being told just what to do by DoH. That certainly needs to change!

18 comments:

Anonymous
said...

Well said David. How very very true. Sadly however, the Department must carry a lot of the blame for they started NEHTA, appointed the wrong people. Now they've closed it down they're getting ready to start all over again.

It is simply a name change, the senior management, assistant secretaries and 2iC's will remain preventing any bold change, innovation or leadership to take root. Don't expect talent to start returning anytime soon, I know I won't being lining up to return.

David, "digital health alive and well". My initial thoughts were about "cockroaches". Digital health has been alive for decades-"well"(Australia)-is a different issue.Has Mr Fleming had his term as leader evaluated by a non in-house source? One also has the impression that future government administrative position is on the cards or even a political post. It has occurred before from NEHTA. I hope there is more collaboration with NEHTA and the eHealth community but as it has been said before "not in my lifetime".[Why am I writing this stuff?]

9:18: These 'managers' main goal is to be disruptive, making themselves indispensable as possible, primarily as simply as being 'yes' men and women to their masters. Much of the rest of the ehealth industry seems to be the same, where it relies on direct or indirect government funding. Someone once described this type as generic managers rent-seeking. (Although the broader political economy is about the same.) It makes one wonder how much genuine talent has been discouraged from working in, or continuing to work in eHealth?

Its clear that once off the track in in the weeds they will continue to push on regardless, wandering in the scrub. Sooner or later they will walk off a cliff but in the meantime the people with an interest in real eHealth need to find a way to progress the science and practice of health as an underground movement. Its hard to keep yourself out of their reach however. GPs should reject the PCEHR but having anticipated that they have filled the troughs with ePIP gold. I am not sure that isn't fools gold however and 50k may not be worth the disruption caused to real world health care. Judging by his past comments Dr Hambleton is clueless and a danger to eHealth. The Hubris is quite disturbing and I am not sure how they develop that hubris as I fail to see any success stories???

The trouble with NEHTA was they always saw it as an IT system and measured its use in terms of number of database records.

Peter Flemming said the PCEHR wasn't a wicked problem. He was right. As an IT system it isn't - it's just a dumb document store.

On the other hand, as a health information system it should be a wicked problem in that it should change the way health professionals work i.e. the solution changes health services work patterns so that the problems associated with health care are simplified.

When it comes to GPs they may as well upload health summaries and collect their little pots of gold. As long as they are careful i.e. do not leave themselves open to litigation, they'll be OK.

It won't change the way they deliver health care, apart from making them data entry clerks, but if they keep it to a minimum and the ePIP payments cover the extra time, they are ahead.

They could take an otherwise healthy patient who's going traveling and put up some basic information. There's a very small chance that the record could be of some use if the patient is involved in some sort of emergency.

The GP wouldn't particularly want another health professional interfering with the care of a patient with serious or complex issues. It could be dangerous for both parties, never mind the patient.

Over time, the real and only measure of the system will be if it is accessed as part of point-of-care health.

That's a difficult thing to strong-arm GPs into doing, especially as there is no penalty for not using the system.

Why would anyone bother applying? It's obviously aimed at following the recruitment guidelines but in reality, all the folks in those positions in NEHTA will just fit in just nicely thank you very much. After all they've had so much experience getting as far as they have already.

David, one has to assume the newly appointed CEO has signed off on the organisation structure and General manager positions. That being the case it is reasonable to assume the CEO will be appointed from the Transitional Authority responsible for overseeing the transition of NEHTA to the ADAH.

Presumably the man who oversaw the the review of NEHTA has his hand up for the CEOs job. He's been heavily promoting the success of his little Hervey Bay Hospital project with Cerner as a model of a paperless hospital for all to follow (forget the cost). Are these reasonable assumptions? We'll know soon enough.

One has to assume the newly appointed CEO has signed off?? What new CEO? My personal assumption is there are other factors at play.

1. July 1st is looming so some things need to be put into action such as advertising roles, vetting applicants and of coarse there are probably a need to address staff concerns.

2. Deal with the disjunctional and collapsed leadership in DoH and NEHTA.

the positions advertised will provide a corporate structure to ensure a caretaker level of operations can be miantianed until the new CEO is appointed formally by the new board. Once that happens I would guess a few new general manager roles will be created and the organisational structure and reporting lines will change.

Politically they must see the need to replace the current leadership and 2iC roles.

Caretaker level of operations until the new CEO is appointed. Mmmmmm I hope the new CEO is pleased with the choice of the various General Managers they have appointed without his involvement!! There are a lot of holes to plug in this titanic to stop it descending deeper into the ocean.

You might all be getting ahead of yourselves, no one publically has been appointed the CEO role or one of the General Managers roles. You cannot simply remove the current C level team without preparing the new one and that will take 4-6 weeks at least, the CEO role has possible been filled or is at least refined down to a couple of options for the board to decide on, plenty of time for the CEO to appoint his staff.

There is also NEHTA end date I am sure they will want to payout those being offered opportunities to explore other careers.

....... they'll always do what he wants them to do. The logical extension of your comment is that he should segue his way into the CEO's slot. He's already on the Board of ADHA (his role would change - no probs), he has already drafted the ADAH strategy (so he's happy with that), he is overseeing the two MHR opt-out pilots (which were probably his idea), he is most likely on the selection committee for the General Managers (or he should be), his remuneration would increase significantly (probably), he would have full responsibility for the success of My Health Record (there's the rub).

"the more he is allowed to get away with, the sooner it will all come crashing down around their ears." ..... and then, as before, they will plot another course and turn the battleship through 90 degrees and just keep sailing on towards the distant horizon. Remember the NEHTA mobile bus, the brouhaha around tiger teams, the Wave 1 and Wave 2 PCEHR rollout and so on and on with one failed initiative after another. Nothing changes.